1. Post-Procedure Complications Monitoring Programme 44th Review Meeting
Friday, 22 August 2014
4:00 - 6:00pm, 4/F, Arthur K C Li Surgical Library
Lui Che Woo Clinical Sciences Building, PWH

2. Attendance Present Prof. Paul B S Lai (Chairman)
Team 1 – Dr. Sunny Cheung & Dr. Ray Hung
Team 2 – Dr. Simon K H Wong & Dr. H C Yip
Team 3 – Dr. Hon Sok Fei & Dr. Eric Y F Cheung
Team 4 – Dr. Micah C K Chan
NS – Dr. W K Mak & Dr. Emily K Y Chan
PSU – Dr. Peter Y H Tam
URO – Dr. Samuel C H Yee
CTS – Prof. Calvin Ng & Dr. Micky Kwok
Mr. Alfred Chan
Ms. Daisy Feng
Ms. Eunice Tam

3. Items discussed
Complications report – June 2014
AOB

4. 1. Complications Report – June 2014

5. June 2014 Summary (case collection progress and Complication rate)
PRS NS
PSUR
URO
CTS
Dept. total
Total cases 58 72 31 52 47 44 57 59
478
Missing cases 1 3 4
Non-Discharged * 2 12
Complication rate and Magnitude
Team 1
Team 2
Team 3
Team 4
PRAS NS
PSUR
URO
CTS
Total
No. of Complication 11 3 4 2 9 5 56 58 72 31 52 47 44 57 59
478
Complication Rate
18.97%
15.28%
8.62%
12.90%
3.85%
19.15%
11.36%
3.51%
15.25%
11.72%

6. Team 1 – Hepato-biliary and Pancreatic Surgery

7. Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 2/10)

8. Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 3/10)

9. Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 4/10)
Culture negative
Rare to have same pathology at the same time

10. Pneumonia (pseudomonas)
Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 5/10)
Surgical strategy needed to be reviewed for this type of case
Need to be proactive in pain control
Pneumonia (pseudomonas)

11. Required re-operation (case 7)
Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 6/10)
Required re-operation (case 7)
Same patient

12. Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 7/10)
Dr. Ray Hung : Review the preparation for patients with anti-coagulants before GS procedure
For discussion at Team 1 Meeting
M & M

13. Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 8/10)
Pathology : perforated adeno-carcinoma
M & M
GI leakage

14. Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 9/10)

15. Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 10/10)

16. Team 2 – Upper Gastro-intestinal Surgery

17. Team 2 – Upper Gastro-intestinal Surgery ( Cont’d 2/9)

18. Team 2 – Upper Gastro-intestinal Surgery ( Cont’d 3/9)
Dr. H C Yip to feedback to Dr. Anthony Fong putting up a drain is not a replacement of proper lavage
Pelvic a abscess collection

19. Team 2 – Upper Gastro-intestinal Surgery
( Cont’d 4/9)

20. Team 2 – Upper Gastro-intestinal Surgery ( Cont’d 5/9)
Feedback to surgeon
Patient woke up & aspirate
Why retrograde decompression
M & M
Very Long
(4 hours 20 mins)

21. Team 2 – Upper Gastro-intestinal Surgery ( Cont’d 6/9)
anastomotic leakage (rare complication for small bowel)
Same patient

22. Team 2 – Upper Gastro-intestinal Surgery ( Cont’d 7/9)
appropriateness of endoscopy setting
case selection for doing in endoscopy centre
Why not lap repair ?

23. Team 2 – Upper Gastro-intestinal Surgery
( Cont’d 8/9)

24. Team 2 – Upper Gastro-intestinal Surgery
( Cont’d 9/9)

25. Team 3 – Colorectal Surgery

26. Team 3 – Colorectal Surgery
( Cont’d 2/6)

27. Team 3 – Colorectal Surgery
( Cont’d 3/6)

28. Team 3 – Colorectal Surgery
(Cont’d 4/6)
( Cont’d 4/6)

29. Team 3 – Colorectal Surgery
( Cont’d 5/6)

30. Team 3 – Colorectal Surgery ( Cont’d 6/6)
Open & Closed

31. Team 4 – Vascular Surgery

32. Team 4 – Vascular Surgery
( Cont’d 2/6)

33. Team 4 – Vascular Surgery ( Cont’d 3/6)
Care from AHNH
(Index OT done in May 2014) and discussed
- Should not have used the ‘glue’ (feedback to radiologist already)

34. Team 4 – Vascular Surgery ( Cont’d 4/6)
Same patient

35. Team 4 – Vascular Surgery
( Cont’d 5/6)

36. Team 4 – Vascular Surgery
( Cont’d 6/6)

37. Plastic, Reconstructive and Aesthetic Surgery

38. Plastic, Reconstructive and Aesthetic Surgery
( Cont’d 2/4)

39. Plastic, Reconstructive and Aesthetic Surgery
( Cont’d 3/4)

40. Plastic, Reconstructive and Aesthetic Surgery
( Cont’d 4/4)

41. Neurosurgery
* Observed a surge in wound infection

42. Neurosurgery
( Cont’d 2/8)

43. Neurosurgery
( Cont’d 3/8)

44. Neurosurgery
( Cont’d 4/8)

45. Neurosurgery
( Cont’d 5/8)
Culture negative
Rare

46. Neurosurgery
( Cont’d 6/8)
No mention of post-mortem

47. Neurosurgery
( Cont’d 7/8)

48. Neurosurgery
( Cont’d 8/8)

49. Paediatric Surgery & Paediatric Urology

50. Paediatric Surgery & Paediatric Urology
( Cont’d 2/6)

51. Paediatric Surgery & Paediatric Urology ( Cont’d 3/6)2
Re-implantation will be difficult

52. Paediatric Surgery & Paediatric Urology ( Cont’d 4/6)1 2
Post-rep ilea's because of require TPN

53. Paediatric Surgery & Paediatric Urology ( Cont’d 5/6)
worthwhile to track adolescent herncorigly

54. Paediatric Surgery & Paediatric Urology
( Cont’d 6/6)

55. Urology

56. Urology
( Cont’d 2/4)

57. Urology
( Cont’d 3/4)

58. Urology
( Cont’d 4/4)

59. Cardiothoracic Surgery

60. Cardiothoracic Surgery
( Cont’d 2/9)

61. Cardiothoracic Surgery ( Cont’d 3/9)
+ cord palsy known complication
Same patient
Not counted

62. Cardiothoracic Surgery
( Cont’d 4/9)

63. Cardiothoracic Surgery
( Cont’d 5/9)

64. Cardiothoracic Surgery ( Cont’d 6/9)
Should look at the practice of using empirical antibiotics (which is not yet evidence – based)

65. Cardiothoracic Surgery ( Cont’d 7/9)
Challenging case because of redo Bentall
still in ICU

66. Cardiothoracic Surgery
( Cont’d 8/9)

67. Cardiothoracic Surgery
( Cont’d 9/9)

68. 2. AOB

69. AOB
Nil

70. THE END